I have been diagnosed with rosacea and have used several different creams prescribed by my dermatologist. Nothing really seems to help. Anything I might use to help the situation?
—L. H., Alabama
Stansbury responds: Rosacea is a chronic and progressive dilation of cutaneous capillaries affecting the nose and central face that most commonly afflicts women between the ages of thirty and fifty. Rosacea may accompany various autoimmune diseases that inflame the capillaries, and may also accompany alcoholism and other conditions associated with vascular congestion and inflammation. Vasodilating substances and stimulants such as caffeine, alcohol and excessive sun should be avoided. Food allergies, constipation, portal congestion and low stomach acidity may occasionally contribute to the condition, as may pancreatic insufficiency and an inability to digest fats due to a lipase insufficiency. Some rosacea patients benefit from restricting animal fats, processed fats and other fats, while supplementing with essential fatty acids—a therapy known to benefit eczema, seborrhea and other forms of dermatitis, which are often concomitant complaints. Although the underlying cause or trigger is often a mystery, you should search for any contributing inflammatory processes in the body. If you have allergies (i.e. hayfever or asthma), you should start by eliminating all food allergens possible and supplementing anti-allergy substances (essential fatty acids and antioxidant vitamins). If there are any digestive difficulties, consider hydrochloric acid and/or pancreatin supplements. If you have a blood vessel disorder (migraines, Raynaud’s syndrome, phlebitis, etc.), work on reducing the reactivity in all blood vessel walls with bioflavonoids, rutin, quercetin, vitamin C, and appropriate herbs, such as feverfew (Tanacetum parthenium), berries (Vaccinium spp.), and hawthorn (Crataegus spp.). If you have evidence of blood vessel congestion, such as liver problems, constipation, varicose veins or hemorrhoids, simply getting the blood moving more may reduce the inflammation in the microcirculatory vessels. Blood movers include yarrow (Achillea millefolium) and dong quai (Angelica sinensis).
Willard responds: Unfortunately, rosacea cannot be treated topically with creams. You have to use both environmental and internal modalities to cure rosacea. It is a chronic, eruptive skin disorder that most often affects the forehead, nose and chin. Even though this inflammation may look similar to acne, it is recognized by small groups of dilated capillaries close to the surface of the skin. This results in blotchy red areas, with small bumps and sometimes pimples. The redness can come and go, but may become relatively permanent. The underlying cause of rosacea has not been determined, but several factors are known to aggravate rosacea, including alcohol, menopausal flushing, hot liquids, spicy foods, exposure to sunlight, extreme temperature or humidity, makeup, local infection, B-vitamin deficiencies and gastrointestinal disorders. I have had good success in reversing rosacea by starting a program with a two-week cleansing regimen. I suggest eating a diet high in raw vegetables and organic grains. Avoid fats (especially saturated), alcohol, caffeine, cheese, chocolate, cocoa, dairy products, salt, sugars and excessively spicy food. Allergies and candida yeast problems may also be involved. Research has shown that rosacea patients have very low hydrochloric acid in their stomachs, affecting other digestive enzymes. I always ask rosacea patients to take 1 to 3 capsules of digestive enzymes (containing hydrochloric acid) with each meal. Often, rosacea sufferers have a high level of Helicobacter pylori bacteria. I use goldenseal (Hydrastis canadensis), coptis (Coptis chinensis) and/or garlic along with the digestive enzymes to lower H. pylori. Since much of the problem is directly related to oil metabolism, you have to be very cautious of not consuming trans-fatty acids (such as margarine) in the diet, while including lots of essential fatty acids. The following is the supplement protocol I most often use: Essential fatty acids, 2,000 mg twice daily; B-complex vitamin, 1 tablet twice daily; digestive formula, 1 to 3 capsules with each meal, depending on meal size; goldenseal or coptis, 500 mg daily; beta-carotene, 25,000 IU twice daily; vitamin C, 1,000 mg twice daily; zinc, 15 mg twice daily; garlic, 1 capsule daily.
Terry Willard is a clinical herbalist, president of the Canadian Association of Herbal Practitioners, and founder of the Wild Rose College of Natural Healing in Calgary, Alberta, Canada. He is the author of eight books and a CD-ROM, Interactive Herbal.
Jill Stansbury has been a naturopathic physician for more than ten years, with a private practice in Battleground, Washington. She is the chair of the Botanical Medicine Department at the National College of Naturopathic Medicine in Portland, Oregon, and the author of many books including Herbs for Health and Healing (Publication International, 1997).
The information offered in “Q & A” is not intended to be a substitute for advice from your health-care provider.